Water Baptism Application
First Name
Last Name
Phone Number
Email Address
Date of Birth
Gender
Male
Female
Mailing Address
When did you receive Christ as your personal Saviour?
Are you presently walking consistently with the Lord in a personal relationship?
Yes
No
What has led you to request water baptism?
Are you willing to give testimony of your personal faith in Jesus as your Saviour?
Yes
No
What is your t-shirt size
Small
Medium
Large
X-Large
2X-Large
3X-Large
Today's Date
Remove
Add Another Person
Submit